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Under the Homelessness Reduction Act (2017), specified public bodies have a duty to refer at-risk households to a local authority housing team. This means a person’s housing situation must be considered whenever they come into contact with a wider public service, such as a hospital or GP practice. 

Some services listed here target specific groups (for example: women, young people, those with mental-health issues), while, for others, the only referral criterion is that patients are homeless or at risk of homelessness.

Safe Surgery initiative (Doctors of the World)

Everyone is eligible to register with a GP and receive primary care services free of charge.  Regardless of a patient’s immigration status or if they are homeless, they have a right to register and it is not a contractual requirement to provide proof of address or identification.  If a patient lives in the area and is homeless (e.g. rough sleeping, sofa surfing, etc.) they can be registered using the practice’s address.

Practices are encouraged to become a Safe Surgery. The safe surgery initiative supports GP practices to tackle the barriers to healthcare faced by people in vulnerable circumstances, especially migrants, refugees, people seeking sanctuary and homeless people.  It is a simple process to sign up and the requirement from practices is minimal, simply a commitment to ensure that anyone seeking to register is welcomed without the requirement to provide documentation.  

The toolkit is designed to help primary care staff support patients living in vulnerable circumstances realise their right to healthcare, get the most out of their General Practice, and access the information they need to keep safe in a COVID-19 context.  The support toolkit is made up of seven very simple steps.

By becoming a Safe Surgery you are showing your patients and community your commitment to equity of access for all.  
The initiative will also support the CQC requirement to support and provide care for different groups of people.

Useful resources

  • Streetlink enables anyone to raise concern around someone sleeping rough. If you are concerned about someone sleeping rough the quickest way to ensure that support reaches them is to refer them using its website.
  • Groundswell has supported homeless people to be involved in delivering solutions to homelessness since 1996: including peer research, client involvement and tackling the health inequalities associated with the experience of homelessness. The service also supports homeless people to address their health needs.
  • Streetvet is a multi-award winning Royal College of Veterinary Surgeons registered practice delivering free care to the homeless and their pets on the streets of London.
  • Dogs on the Streets is a volunteer-run, not-for-profit charity dedicated to the welfare of dogs belonging to the UK’s homeless community.
  • The Pavement is a booklet which comes out every two months and has details of shelters, foodbanks, and health services for homeless people. It's useful for signposting and small enough to fit in a person's pocket. Practices can order copies by emailing london@thepavement.org.uk

Duty to Prevent framework: Avoiding homelessness

Islington Council is working towards a Duty to Prevent framework to reduce the likelihood of a person becoming homeless.

If one of your Islington patients is homeless or at risk of homelessness, please refer them to the council’s Housing Needs service as soon as possible. 

This is targeting patients whose current or preferred local authority is Islington Council. However, all boroughs can refer, because non-Islington GPs may be supporting someone who is linked to the Islington Local Authority, or if a referral for a non-Islington resident is made to the Islington Access team inappropriately, the referral won’t be rejected but will be redirected to the most appropriate local authority.

From the week commencing 19 July 2012, the Duty to Prevent referral form will be embedded in EMIS.  

For more information about when an individual may benefit from this support and other information, visit the Islington Council Website

Area specific guidance for Islington

London Borough of Islington’s priority is to help people avoid becoming homeless. The council housing team can do this by negotiating with the people your patients live with or their landlord, giving advice, or by helping them to find another home quickly. To refer someone to Islington Council for support with housing
t:  020 7527 6371
e: advice.housing@islington.gov.uk 
w: London Borough of Islington Homelessness website

Integrated Network (MDT discussion): If you are concerned about a complex patient who is homeless then please refer to the INC team for MDT discussion through usual routes or contact Ayse Cinko
e: ayse.cinko@nhs.net

Area specific guidance for Camden

Camden Food Bank offers food vouchers for homeless patients. To order vouchers, e: admin@rccgcitychurch.org or call 020 7387 4551 or 07984796902 or 07947197575. See downloads for the patient leaflet.


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